DefinitionBody dysmorphic disorder is a type of chronic mental illness in which you can't stop thinking about a flaw with your appearance — a flaw either that is minor or that you imagine. But to you, your appearance seems so shameful and distressing that you don't want to be seen by anyone. Body dysmorphic disorder has sometimes been called "imagined ugliness."

When you have body dysmorphic disorder, you intensely obsess over your appearance and body image, often for many hours a day. You may seek out numerous cosmetic procedures to try to "fix" your perceived flaws but never are satisfied. Body dysmorphic disorder is also known as dysmorphophobia, or the fear of having a deformity.

The body feature you focus on may change over time. You may be so convinced about your perceived flaws that you become delusional, imagining something about your body that's not true, no matter how much someone tries to convince you otherwise.

When to see a doctorShame and embarrassment about your appearance may keep you from seeking treatment for body dysmorphic disorder. But if you have any signs or symptoms of body dysmorphic disorder, see your doctor, mental health provider or other health professional. Body dysmorphic disorder usually doesn't get better on its own, and if untreated, it may get worse over time and lead to suicidal thoughts and behavior.

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surely if you have people commenting on your body part it must be true and need surgery as people like david beckham dont get anyone saying your nose is big or anything else,and also i do not think that doctors gps take it seriously as i have seen on many web sites it is a serious mental disorder that takes over your life,some days worse than others and made worse when you see youself in mirrors,even reflected in windows and then the mind works overtime with what can i do about it and only surgery would solve the problem.

it is completely irrelevant if people comment about your appearance,BDD is diagnosed when you cant function because of distress about appearance unless of course you have an medically diagnosed facial deformity in which case the treatment would actually be the same as bdd if it affected you greatly.David beckham looks effeminate to most men and many women like a more rough looking face evn with a big nose.However its all about how your own body image affects you and beckhan could just as easily have BDD no matter how many people thought he was gorgeous(he looks gay to me)

I have most of those symptoms:- Preoccupation with your physical appearance- Strong belief that you have an abnormality or defect in your appearance that makes you ugly- Frequently examining yourself in the mirror or, conversely, avoiding mirrors altogether (at home i stare at myself in the mirror and at school I avoid them!)- Believing that others take special notice of your appearance in a negative way- Frequent cosmetic procedures with little satisfaction (not yet.. I want to get plastic surgery)- Excessive grooming, such as hair plucking- Feeling extremely self-conscious- Refusing to appear in pictures- Comparing your appearance with that of others- Avoiding social situations- Wearing excessive makeup or clothing to camouflage perceived flaws (hahha so true, and I still think I'm hideous with makeup!)

I thought this would be good to add. If you look through all of the posts here, everyone seems to say the same thing. "People say i look normal but when I look in the mirror, I look ugly/disfigured/hideous." It is important to understand the cause of that and the answer seems to be that those of us with BDD have visual processing abnormalities, which are often severe. These are especially prevalent when looking at face, skin, and hair. We have problems with interpreting the size and shape of certain features correctly, as well as an inability to see details and take things as a whole, often seeing ourselves completely out of context. The way that our brains take in visual information and interpret that information is very different from people without this disorder, meaning that a significant portion of these symptoms are caused by neurological deficits and not by actual physical deformities.

So for those of us with BDD, what we see in the mirror has little to no basis in reality. Not just a little bit off or some minor differences between what you see and what other people see, we are talking significant disparity between what we see and what is reality. This is usually made worse by the OCD like symptoms. The distortions can become worse and worse the more we check and the more we obsess, creating a rather viscous downward spiral that usually leads to delusion.

The good news is, SSRI's seem to attack the problem from several angles. Anti-depressants stop or significantly reduce obsessions, which in turn reduces the temptation to perform whatever your compulsion may be, usually checking for problems in the mirror. And they also seem to help correct the visual distortions. Probably not 100% but significantly enough in a majority of people. That is why SSRI's are important and of course therapy, to prevent carrying out the old behaviors and getting caught up in the dysfunctional beliefs.

I just wanted to post a few quotes from different sources about the typical symptoms of this disorder. When I first started to wonder if I had a disorder, these helped pull me out of my near delusional state.

"Major symptom of BDD is a tormenting doubt; the underlying question related to uncertainty about ones body part, or appearance. It is important to mention that symptoms can shift from concern about one aspect of appearance to another at any time."

"It is not uncommon for people suffering from BDD to perceive their own image so distorted, while they may be able to appraise appropriately accurate appearances of others, at the same time they fail to objectively appraise appearance of self. What people with BDD perceive is actually similar to the reflection we have all seen in a distorted carnival fun-house mirror"

"The distress caused by this fixation can lead to compulsive behaviors such as repeated questioning and seeking reassurance, endless matching of the clothing, social withdrawal, impairments or nonexistence of interpersonal intimate relationships, inability to tolerate social situations, constant checking for physical imperfections through touching, testing for bumps, feeling for symmetry, searching for flaws, skin picking, measuring the waste line, noses, counting hairs that fell out, etc."

"When concern with ones appearance interferes with social/occupational performance it may be a symptom of BDD. Simply put, if a persons appearance becomes the center of their focus and they can no longer maintain a healthy perspective on life it becomes an unhealthy obsession"

"People with BDD misperceive what they see. There is misinterpretation and distortion in what is the actual flaw."

"People with BDD certainly do experience extreme self-consciousness. It sometimes becomes evident begins avoiding social situations, and not wanting others to see them. BDD leads people to sense that other people are criticizing their perceived imperfections. Around others, they get the feeling of being scrutinized under magnifying glass. As these fixations intensify the belief that people are looking at the perceived "defects" seems rational. Other's actions are interpreted in reference to the particular "flaw" and it seems that people are starring, laughing, and discussing them behind their backs."

"People with BDD believe that some aspect of their appearance is not perfect. They spend endless amounts of time and a lot of effort trying to perfect that particular aspect of appearance. If their "area of concern" is not perfect [it never is], they are reluctant to leave the house or continue with the daily activities. It is not only that they know that they are not perfect, but also they believe that they will be highly scrutinized by others (watched under magnifying glass)"

"The three most common areas of which those suffering from BDD will feel critical have to do with the face: the hair, the skin, and the nose. Outside opinion will typically disagree and may protest that there even is a defect. The defect exists in the eyes of the beholder, and one with BDD really does feel as if they see something there that is defective."

"Body dysmorphic disorder causes sufferers to believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance."

"They feel too embarrassed and unwilling to accept that others will tell the sufferer that he or she is suffering from a disorder"

"The sufferer believes that fixing the "deformity" is the only goal, and that if there is a disorder, it was caused by the deformity. In extreme cases, patients report that they would rather suffer from their symptoms than be 'convinced' into believing that they have no deformity."

"Studies have found that Cognitive Behavior Therapy (CBT) has proven effective. In a study of 54 BDD patients who were randomly assigned to Cognitive Behavior Therapy or no treatment, BDD symptoms decreased significantly in those patients undergoing CBT. BDD was eliminated in 82% of cases at post treatment and 77% at follow-up. Due to believed low levels of serotonin in the brain, another commonly used treatment is SSRI drugs (Selective Serotonin Reuptake Inhibitor). 74 subjects were enrolled in a placebo-controlled study group to evaluate the efficiency of fluoxetine hydrochloride (Prozac); patients were enrolled in a 12-weeks, double-blind, randomized study. At the end of treatment, 53% of patients responded to the fluoxetine."

"BDD usually appears during early adolescence, and, when left untreated, is often a chronic condition."

"BDD patients may process faces in a piecemeal manner, while healthy controls’ perception of faces may be more conﬁgural and holistic. These laterality patterns in the BDD participants suggest a bias for local, or detail oriented, processing of faces over global processing.”

"Patients’ thoughts associated with the perceived defect in their physical appearance may actually represent such a distortion of reality that their belief is delusional...the nondelusional patient displays little or no insight. For a brief time they may admit that they might be wrong about their preoccupation."

"At one time or another we all worry about our appearance, but when you wake up degrading your nose, hair, chest, WEIGHT, etc. and then continuing to have these thoughts all day, that's when there is a problem."

"The problem, though, is that all of these self-degrading thoughts about a perceived flaw are distorted. Many, many times the supposed flaw doesn't even exist, or an "imperfect" body part is blown entirely out of proportion. However, the person themselves cannot see that what they believe is distorted. Many hold the belief that they are seeing all of this, therefore it MUST be true.Nothing is good enough because the person cannot see that what they have done is absolutely fine"

Wow, this was some really amazing reading. I do a lot of online research concerning severe mental illnesses because I like to know what is going on with me and I like to see if I can diagnose others (which I normally can) and I have learned just as much from this forum as I have doing my research on this topic. I just started coming to this site tonight, so I don't know anyone or anything. I have just been posting my story around so that maybe it might help someone somewhere. I have several severe mental illnesses. I am bipolar and suffer from psychosis, paranoid personality disorder, anti-social personality disorder, schizotypal personality disorder, borderline personality disorder, Body dysmorphic disorder, severe social anxiety disorder, severe social phobia, and for the past three years I have become a full blown agoraphobic. I leave my house every three to six months to go to the doctor so I can get refills on my medication. Without my medication I would be really crazy. I am really serious about that. I am a maniac when I do not take my medication. I am always in fear of having my medicaid taken away from me. I don't know how I would be able to cope with life. My depression is so awful that I really would rather be dead than to go through feeling like that again. My life has been a living hell because I wasn't diagnosed correctly until just a few years ago. I was not your normal child when I was in kindergarten. I stabbed a kid in the leg with my pencil because he wouldn't leave me alone. They had to take him to the hospital to get the lead out of his leg. Then in fourth grade, when I started getting made fun of/picked on, I didn't just get angry like a normal kid; I wanted to really hurt people and possibly even worse than that. I was so full of rage growing up. I hated everyone including myself. I even got angry with God for making me look this way. I always believed that everything happens for a reason, but I have not found the reason for this and I am going to be 40 next month. I thought that I would have been able to grow out of this fear of being made fun of when I got older, but it has only gotten worse. I won't even walk downstairs to check my mail because I don't want the neighbors to see me in the hall. It is really bad here because it is all college kids and they are always hanging out in the hallways. I don't want them to see me. It is really such a waste, though. I have a brilliant mind that I could put to good use if I could get out of this apartment but I do not see that happening any time soon. I am in college online taking web design courses so that I will be able to work from home when I get my degree. I have one daughter left at home who is 15. I missed my oldest daughter's graduation because I couldn't be around all of those people. My other daughter did not finish college (she is in the hospital tonight), and my youngest is throwing her future away goofing off with boys. I understand because I was a wild child and remember what it was like at that age, but she was such a good kid until she got with this stupid boy she is with now. He treats her like crap and I don't know what to do. He is my best friend's kid. Anyway, my kids have been made fun of too. I don't know how any of us have survived it. I am one of those people that you either think I am cute or I am butt ugly. There is no in between. I know I am butt ugly. I feel like I am too ugly to be alive, but there is this other part of me that feels like I am above everyone else spiritually and also because of the wisdom that I have acquired. I feel like I am the only one who has feelings and that the human race is totally evil. I do not mind being in my house because there is nothing and no one out there that I want to see. This is my life inside. This is what I've got and what I have to work with. There has been NO medication that has made my BDD any better whatsoever. Nothing relieves the anguish. I'd like to hear some of your stories so please respond. I have to get back to my work for college, but I will be checking back in awhile.

Is there a list here of any recommended books and workbooks? I have a couple my therapist gave me, but she also suggested I look for some workbooks specifically. And also, I know it might not even exist, but are there any books which focus on the face instead of the whole body? Sorry if I'm asking in the wrong thread. Thanks.

jestersnow2012 wrote: This is my life inside. This is what I've got and what I have to work with. There has been NO medication that has made my BDD any better whatsoever. Nothing relieves the anguish. I'd like to hear some of your stories so please respond. I have to get back to my work for college, but I will be checking back in awhile.

After being in "remission" for a while, I had a full-fledged attack over the past two days and I cannot stop taking pictures of myself in order to determine once and for all whether I'm "cute or butt ugly." Sometimes I look cute, and sometimes I look like a rat. Yes, a rat. That's a new one on me -- today was the first time I thought I looked like a rat.

I've managed to have a career working from home, but I haven't been able to work for the past two days. I don't know how I've survived, and I'm considerably older than you and terrified about the future.

So nothing at all gives you solace? I turned to God a long time ago, and He helps some, but the pain of being unloved and unwanted continues. I have tried to accept myself the way God accepts me, and to tell myself that this is temporary, but sometimes I lose or fear I'm losing my faith. I thought I had a robust relationship with Christ, but at times I wonder. I don't mean to offend anyone by referring to religion; I just wanted to indicate where I've found relief.

It used to be that after taking pictures, something would click in my head and I would look at a video I'd taken and thought I looked like a monster in the day before --- and then seeing it days later think it wasn't so bad. I am confused. I am not sure how bad I am. I know I have a defect, and it's inoperable because of its nature (my bone structure). Even if I had jaw surgery, my face wouldn't be "right" because it's just shaped so oddly that changing that one thing wouldn't help matters.

Then there are days I spend online looking at deformed people, people with terrible disfigurements, and there is a multitude of pictures online. I have amassed a collection of them and try to use them to convince myself that I'm not so bad after all. Sometimes it works.